Christina G Wong1,2, Kelsey R Thomas1,2, Emily C Edmonds1,2, Alexandra J Weigand1,2, Katherine J Bangen1,2, Joel S Eppig3, Amy J Jak1,2, Sherral A Devine4,5, Lisa Delano-Wood1,2, David J Libon6, Steven D Edland7,8, Rhoda Au4,5,9,10, Mark W Bondi11,12. 1. Veteran Affairs San Diego Healthcare System, San Diego, California, USA. 2. Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, California, USA. 3. San Diego State University/University of California, San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego, California, USA. 4. The Framingham Heart Study, Framingham, Massachusetts, USA. 5. Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA. 6. Department of Geriatrics and Gerontology and the Department of Psychology, School of Osteopathic Medicine, New Jersey Institute for Successful Aging, Rowan University, Glassboro, New Jersey, USA. 7. Department of Biostatistics, University of California, San Diego, La Jolla, California, USA. 8. Department of Family and Preventative Medicine, University of California, San Diego, La Jolla, California, USA. 9. Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA. 10. Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA. 11. Veteran Affairs San Diego Healthcare System, San Diego, California, USA, mbondi@ucsd.edu. 12. Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, California, USA, mbondi@ucsd.edu.
Abstract
BACKGROUND/AIMS: Mild cognitive impairment (MCI) lacks a "gold standard" operational definition. The Jak/Bondi actuarial neuropsychological criteria for MCI are associated with improved diagnostic stability and prediction of progression to dementia compared to conventional MCI diagnostic approaches, although its utility in diagnosing MCI in old-old individuals (age 75+) is unknown. Therefore, we investigated the applicability of neuropsychological MCI criteria among old-old from the Framingham Heart Study. METHODS: A total of 347 adults (ages 79-102) were classified as cognitively normal or MCI via Jak/Bondi and conventional Petersen/Winblad criteria, which differ on cutoffs for cognitive impairment and number of impaired scores required for a diagnosis. Cox models examined MCI status in predicting risk of progression to dementia. RESULTS: MCI diagnosed by both the Jak/Bondi and Petersen/Winblad criteria was associated with incident dementia; however, when both criteria were included in the regression model together, only the Jak/Bondi criteria remained statistically significant. At follow-up, the Jak/Bondi criteria had a lower MCI-to-normal reversion rate than the Petersen/Winblad criteria. CONCLUSIONS: Our findings are consistent with previous research on the Jak/Bondi criteria and support the use of a comprehensive neuropsychological diagnostic approach for MCI among old-old individuals.
BACKGROUND/AIMS: Mild cognitive impairment (MCI) lacks a "gold standard" operational definition. The Jak/Bondi actuarial neuropsychological criteria for MCI are associated with improved diagnostic stability and prediction of progression to dementia compared to conventional MCI diagnostic approaches, although its utility in diagnosing MCI in old-old individuals (age 75+) is unknown. Therefore, we investigated the applicability of neuropsychological MCI criteria among old-old from the Framingham Heart Study. METHODS: A total of 347 adults (ages 79-102) were classified as cognitively normal or MCI via Jak/Bondi and conventional Petersen/Winblad criteria, which differ on cutoffs for cognitive impairment and number of impaired scores required for a diagnosis. Cox models examined MCI status in predicting risk of progression to dementia. RESULTS: MCI diagnosed by both the Jak/Bondi and Petersen/Winblad criteria was associated with incident dementia; however, when both criteria were included in the regression model together, only the Jak/Bondi criteria remained statistically significant. At follow-up, the Jak/Bondi criteria had a lower MCI-to-normal reversion rate than the Petersen/Winblad criteria. CONCLUSIONS: Our findings are consistent with previous research on the Jak/Bondi criteria and support the use of a comprehensive neuropsychological diagnostic approach for MCI among old-old individuals.
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